NBME 6 block 4 q1 to 50 - maryam2009

[ArchivalUser]

Welcome... ,Please choose and answer the Qs in order. looking for more volunteers. ... Any help would be appreciated .Thank you.

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1..e PCL

The drawer test is a test used by physicians to detect rupture of the cruciate ligaments in the knee. The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table. The examiner sits on the patient's feet and grasps the patient's tibia and pulls it forward (anterior drawer test) or backward (posterior drawer test). If the tibia pulls forward or backward more than normal, the test is considered positive. Excessive displacement of the tibia anteriorly indicates that the ACL is likely torn, whereas excessive posterior displacement of the tibia indicates that the PCL is likely torn. The Lachman test is a variation on this test in which the knee is in thirty degrees flexion

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2...AAA

A compression fracture occurs when the normal vertebral body of the spine is squished, or compressed, to a smaller height. This injury tends to happen in two groups of people. First, are patients who are involved in traumatic accidents. When a load placed on the vertebrae exceeds its stability, it may collapse. This is commonly seen after a fall. The second, and much more common, group of patients are those with osteoporosis.

Osteoporosis is a condition that causes a thinning of the bone. As the bone thins out, it is less able to support a load. Therefore patients with osteoporosis may develop compression fractures without severe injuries, even in their daily activities

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3.CC

Anorexia nervosa ....Adolescents with eating behaviors associated with anorexia are at high risk for anxiety and depression in young adulthood.
Hormonal Changes
One of the most serious effects of anorexia nervosa is hormonal changes, which can have severe health consequences.

Reproductive hormones, including estrogen and dehydroepiandrosterone (DHEA), are lower. Estrogen is important for healthy hearts and bones. DHEA, a weak male hormone, may also be important for bone health and for other functions.
Thyroid hormones are lower.
Stress hormones are higher.
Growth hormones are lower. Children and adolescents with anorexia may experience retarded growth.
The result of many of these hormonal abnormalities in women is long-term, irregular or absent menstruation (amenorrhea). This can occur early on in anorexia, even before severe weight loss. Over time this causes infertility, bone loss, and other problems.

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4.BB

oculomotor nerve controls most of the eye muscles, it may be easier to detect damage to it. Damage to this nerve, termed oculomotor nerve palsy is also known by the down n' out symptoms, because of the position of the affected eye.

Pupillary reflex:
The oculomotor nerve also controls the constriction of the pupils and thickening of the lens of the eye. This can be tested in two main ways.
1.By moving a finger toward a person's face to induce accommodation, as well as his going cross-eyed, his pupils should constrict.

2.Shining a light into one eye should result in equal constriction of the other eye. The neurons in the optic nerve decussate in the optic chiasm with some crossing to the contralateral optic nerve tract. This is the basis of the "swinging-flashlight test".

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5.DD

1.Mania ...elevated or irritable mood, arousal, and/or energy levels.
2.Hypomania...is distinguished from mania by the absence of psychotic symptoms and grandiosity, and by its lower degree of impact on functioning.
3.Mixed state....is a condition during which symptoms of mania and depression occur simultaneously

Bipolar II
Hypomania is a feature of bipolar II disorder...... at least one hypomanic episode and at least one major depressive episode,but no manic episode.
It is believed to be under-diagnosed because hypomanic behavior often presents as incredibly high-functioning behavior. at highest risk of suicide and it very difficult to distinguish from depression.
Treatment: Lithium and Lamictal are considered "gold standard" medications

Bipolar I

at least one manic or mixed episode
A mixed state must meet the criteria for a major depressive episode and a manic episode nearly every day for at least one week

Treatment:MedicationMood stabilizers

1.Lithium carbonate, but it has a narrow therapeutic range
2.Anticonvulsants, such as sodium valproate, carbamazepine or lamotrigine
3.Antipsychotics, such as quetiapine, risperidone, olanzapine or aripiprazole
4.Electroconvulsive therapy, a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect

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6.
waiting for correct answer

The median is the middle number......your numbers have to be listed in numerical order,

1 2 3.......it should be 2

7.AA

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7..
my answer key is AA but it seems EE is the correct answer please clarify the correct answer,TY

8.AA

The bronchial arteries supply blood to the bronchi and connective tissue of the lungs. They travel with and branch with the bronchi, ending about at the level of the respiratory bronchioles. They anastomose with the branches of the pulmonary arteries, and together, they supply the visceral pleura of the lung in the process.

Note that much of the blood supplied by the bronchial arteries is returned via the pulmonary veins rather than the bronchial veins.

Each bronchial artery also has a branch that supplies the esophagus.

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9.DD.....

CRESCENT -SHAPED HEMORRHAGE THAT CROSS SUTURE LINES AND CAN NOT CROSS FALX,TENTORIUM

subdural hematoma....rupture of bridging vein.....venous bleeding with delayed onset of symptoms
seen in elderly ,alcoholics,blunt truma,in shaken baby

predisposing factor......BRAIN ATROPHY,SHAKING,WHIPLASH

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10.EE
Posterior longitudinal ligament
It is broader above than below, and thicker in the thoracic than in the cervical and lumbar regions. The ligament is more narrow at the vertebral bodies and wider at the intervertebral disc space which is more pronounced than the anterior longitudinal ligament. This is significant in understanding certain pathological conditions of the spine such as the typical location for a spinal disc herniation.

http://upload.wikimedia.org/wikipedia/co...ray302.png